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The Family Counseling Center for Recovery offers the full continuum of outpatient care from assessment and ambulatory detoxification to ongoing therapy for long-term recovery. Clients seeking Methadone treatment will be required to present a photo ID and pay $84.00 to cover the first week of Methadone treatment.
Please call our office for information regarding the cost of Buprenorphine treatment options. The materials posted on this website are for personal, non-commercial use only and may be downloaded only for personal use. Family Counseling Center for Recovery offers Intensive Outpatient Programs for Adults, Adolescents and Families in addition to Methadone Detoxification, Assessment and Intervention, Impaired Professionals Program, Hypnosis and Addictions Treatment, Family Group, Heroin Addiction, Alchol Abuse, Chronic Pain and Addictions, Prescription Drug Addiction, Adolescent Substance Abuse, Adolescent Treatment Services, Ambulatory Detoxification, Clonidine Detoxification, Suboxone Detoxification, Naltrexone Medication, Auricular Acupuncture, Daily Medical Attention, Individual, Group and Family Therapy, as well as Financial Assistance available through community resources. The Savvy™ mobile medication workstation from Omnicell should not be confused with ordinary hospital medication carts.
This fully integrated solution features Omnicell's Anywhere RN™ software application and a wireless, medical-grade mobile workstation. The Anywhere RN software allows nurses to order medications in quieter areas away from interruptions, assisting in preventing medication errors. Savvy provides secure transport of medications from the ADC to the point-of-care, creating a critical layer of accountability and addressing ISMP recommendations for safe transport of medications.
Nurses can place all needed patient medications for a medication pass into patient-assigned locking drawers and then move from room to room, instead of returning to the ADC between each patient. Reduces trips back to the cabinet to record medication waste, which can now be done remotely. Savvy seamlessly integrates the Omnicell ADC, mobile workstation, and bedside point-of-care (BPOC) systems during the medication administration process, to enable a closed-loop process for tracking medication accountability. Savvy is part of the Unity platform of solutions that share a single database, helping to eliminate redundant data entry that can lead to errors.
Eliminates the manual process of labeling drawers: patient-specific drawers (up to 12) are automatically assigned via the software. Features independently locking drawers, which minimizes the risk of administering the wrong medication to a patient. Omnicell’s unique guiding lights technology helps nurses quickly identify the drawer that has been unlocked, adding speed and convenience to the medication administration process. Lithium-ion hot-swap battery system (2 batteries) provides up to 18 hours of continuous run time. Battery charging station conveniently charges depleted battery without having to plug the Savvy unit into a power outlet. Nurses can focus on patients without worrying about running out of power at a critical time. Nurses are the largest segment of the healthcare professions in the workplace and we are also very likely to have some kind of work-related injury over their career.
A hospital near here, Christiana Hospital, in Delaware, has ceiling mounted lifts in every room to allow them to move patients safely so that you’re not lifting them in and out of the bed.
Ultimately we have to take care of ourselves and make sure that our facilities have policies in place that serves to change the way we handle patients and move them. Looking for something?Use the form below to search the site:Still not finding what you're looking for?
When medication errors arise due to inaccurate or unknown patient weights, the dose of a prescribed medication could be significantly different from what is appropriate. More than half of the most commonly abused controlled substances are prescription medications.
While the referring physician will provide treatment for any pain or medical conditions, the FCCR staff can begin an outpatient detoxification program, if indicated. We work closely with inpatient hospitals and treatment centers when inpatient care is indicated. Savvy streamlines the medication administration process and provides safe and secure transportation of medications from the automated dispensing cabinet (ADC) to the patient's bedside. Because clinicians can remotely select patient medications quickly and securely, from any location at any time, their transaction time at the ADC is reduced, providing more time for direct patient care. Nurses can use the Savvy mobile medication workstation, which integrates Omnicell's Anywhere RN software, to request, retrieve, and deliver all of their patients' medications for a medication pass with a single trip to the cabinet, without compromising on security. Often these are lower back injuries from lifting accidents and of course what happens when you have those injuries. Nurses were surveyed about this and found that during the situations where they were injured, they were distracted, were more likely to cause medication errors and have adverse events happen. I injured my back a long time ago and then I was paramedic and did more bad lifting positions in the field.


The Family Counseling Center has developed a program of cooperation with local physicians to assist in treating this population.
During the detoxification process, clients will learn safe alternative methods to assist them with ongoing symptoms. Nurses are often not very good at taking care of ourselves but we are good at taking care of other people. Does your facility have listed lifting assistants, aides and tools that can help you lift a patient safely? It was because, hey, I couldn’t get out there and do the things I used to do when I was a young gun, running on the street in an ambulance. I needed to do something different and nursing was a little bit easier on the back than what I had been doing. But the flip-side of that is we are often taking care of others, to our own detriment in some cases.
Breakdowns described in reports most frequently involved failures to obtain accurate patient weight measurements. Strategies to address these problems include providing all units with the necessary equipment to weigh patients, weighing every patient during triage or admission to facilities, and weighing patients and documenting patient weights only in kilograms. Both height and weight are needed to use nomograms to determine body surface area and body mass index.
A Look at the NumbersThere is little information in the literature that specifically mentions medication errors that result from missing or inaccurate patient weights.
Top Five Medication Error Event Types Associated with   Wrong Weights (n=448) Table 2 lists events by the top five units in which the event occurred, representing 54% of all reports. A national survey of EDs shows that more than 50% of all patients admitted to a hospital came through the ED. Units Commonly Involved in Medication Errors Involving   Wrong Weights (n=259) A review of the medications commonly reported reveals two key attributes.
Second, 5 of the top 10 medications involved, representing 236 (49%) of all reports, are high-alert medications. High-alert medications are drugs that bear a heightened risk of causing significant patient harm when they are used in error.6  Table 3. Top 10 Medications Involved in Wrong-Weight Medication   Error Reports (n=304)  Further AnalysisThe second step in the analysis process included a review of each report’s description of the event to determine what specifically went wrong in these reports. There are times when patients arriving at hospitals may not be weighed; for example, if a patient is admitted for an emergency, is not ambulant, or is unable to communicate his or her weight. The study results showed that staff members’ estimation of weight was poor, with 47% of estimates at least 10% different and 19% of the estimates were at least 20% different from the measured weights.11Another prospective study of adult patients presenting to an urban ED assessed the accuracy of estimations of patients’ weight by the patients themselves, physicians, and nurses in the ED. The authors concluded that when a patient is unable to be weighed, the patient’s own weight estimate should be used.12In a third prospective, descriptive study of trauma patients, healthcare practitioners (physicians, trauma residents, and trauma bay nurses) estimated patients’ weights. The patient was never weighed prior to starting the weight-based heparin nomogram.A patient presented to the ED after having taken an overdose of Tylenol PM. The patient’s initial acetaminophen level [about 100] and an acetylcysteine (Mucomyst®) infusion was ordered based on the established pharmacy protocol. When the patient reached the floor and was actually weighed, [his or her] weight was found to be 23 kg less than originally stated. The pharmacist was notified, and the infusion rate adjusted based on this knowledge.A report was given to ICU nurse from the ED. This weight was only documented in [the computer system] under the Diprivan® (propofol) medication calculation.
Upon transfer to the bariatric bed, the patient’s weight was confirmed at 250 lb and not 419 lb.
According to the ED, the patient’s weight was an estimate because the ED could not weigh the patient prior to administration of the medications.
The patient was unable to be weighed due to [his or her] critical status to stand on scale in ED.
After the patient arrived to the floor, [personnel] were able to weigh [the patient, whose] weight was recorded as 91 kg.
For example, when patients are transferred from facility to facility or within a facility between units, practitioners often assume that the weight documented in the medical record is accurate and up-to-date. One such scenario was reported to the Authority.A patient was admitted through the emergency room.
The demographic sheet obtained from the nursing home, which was used to determine the patient’s weight, listed [the weight] at 253 lb.
The error was corrected based on correct weight of patient.Although there are studies that show that a patient’s own weight estimate can be more accurate than a healthcare practitioner’s, problems can occur when solely relying on a patient’s stated weight.


One example reported to the Institute for Safe Medication Practices (ISMP) involved an ED patient with deep vein thrombosis who purposely understated her weight as 160 lb because she did not want her husband to know that she actually weighed 180 lb.
A short time later, a pharmacist working in the unit asked the patient to step on a scale and an error was averted. While a 20 lb difference in an adult may not cause a problem, larger discrepancies between a patient’s stated weight and a measured weight have been reported to ISMP (up to 100 pounds).14Finally, the patient’s weight may not be communicated to appropriate healthcare practitioners. For example, the weight, especially an accurate weight, may not be provided to pharmacy, either on paper or electronically, to calculate or double check weight-based drug doses.
In a survey performed by ISMP and the Pediatric Pharmacy Advocacy Group to determine what medication safety practices were in place for pediatric patients in both critical care and noncritical care units, only about half of all respondents reported that the patient’s weight is always entered into the computer before processing orders to allow the system to warn practitioners about drug doses that exceed safe limits.15Errors with Documenting WeightsMost patients are weighed in pounds, both in their home and in the healthcare organization. But weighing and documenting patients’ weights in pounds introduces the need to then calculate the weight into kilograms, an error-prone process,16 for weight-based and other dosing. However, the greater problem is obtaining the weight in pounds then failing to convert and document that weight in kilograms, resulting in more than two-fold dosing errors. In fact, more than 25% of the 479 reports mention breakdowns that occurred when the patient’s weight, measured in pounds or kilograms, was erroneously documented as the patient’s weight in kilograms or pounds, respectively. Reports submitted to the Authority illustrate that this can occur with weights documented in a paper-based patient record or computerized order-entry systems, as well as weights entered into infusion pumps.A patient’s weight was inaccurately reported to the pharmacy using pounds instead of kilograms. Another nurse did not convert the patient’s weight from pounds to kilograms.A patient’s weight was estimated at approximately 180 lb. The nurse did not convert the pounds into kilograms when drawing up the Lovenox® injection. The nurse administered 180 mg of Lovenox.A patient in the ED was ordered “fosphenytoin IV stat” for break-through seizures.
The resident entered the patient’s weight into the CPOE [computerized prescriber order entry] system in pounds instead of kilograms (44 lb versus 20 kg). The patient received an overdose of the medication that resulted in toxicity.Upon checking IV pump settings, both the weight and kilograms were incorrectly programmed into pump. Once the correct weight was programmed into the pump, the dose of dopamine was decreased, which decreased patient’s blood pressure, resulting in need to increase dopamine and increase monitoring.Ideal versus Actual Body WeightA third, less frequently reported error involving patient weights is the inappropriate use of either ideal body weight or actual body weight given the patient’s condition or specific medication. For certain types of patients, medications may be dosed on an ideal body weight instead of an actual body weight.
For example, if a patient is dehydrated, his or her actual weight will be lower than his or her ideal body weight, and conversely, a patient who is obese will have an actual body weight that is greater than his or her ideal body weight. Examples reported to the Authority include the following:Patient was started on a heparin infusion per protocol.
A partial thromboplastin time (PTT) level came back from the lab at high panic [greater than] 249. According to protocol, the heparin infusion was stopped for three hours and another PTT drawn. When the second PTT results were reported, the infusion was recalculated and the original calculations were noted to have been made using ideal body weight, when actual body weight should have been used in this case (the actual body weight in this patient was less than ideal body weight).
New drip calculations were done and verified with pharmacy, as well as another registered nurse on the unit.The physician ordered “acyclovir 2 gm IV” based on patient’s actual weight of 98 kg.
The pharmacy did not clarify the high dose order with the physician.Risk Reduction StrategiesObtain WeightsIt is vitally important that an accurate weight is obtained when patients arrive at a healthcare facility. Establish a communication process that facilitates the timely transfer of accurate patient weights from nursing to the pharmacy.17Build a hard stop for patient weight into CPOE and pharmacy order entry systems. In a study to evaluate preprinted order forms, a form was designed to guide prescribers through the process of handwriting a complete inpatient prescription by using forcing functions. To assess the effectiveness of this intervention, medication prescriptions were collected for two weeks before and after introduction of the new forms and evaluated for compliance with medication prescription guidelines. ISMP 2007 survey on HIGH-ALERT medications: differences between nursing and pharmacy perspectives still prevalent.
Errors in weight estimation in the emergency department: comparing performances by providers and patients. Estimated height, weight, and body mass index: implications for research and patient safety. Hospital survey shows much more needs to be done to protect pediatric patients from medication errors. Preprinted prescription forms decrease incomplete handwritten medication prescriptions in a neonatal intensive care unit.



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